Health officials in South Sudan were scrambling Monday to contain a cholera outbreak as the death toll from the diarrheal disease rose and infections were reported beyond the capital, Juba, and in other parts of Central Equatoria state and in distant Upper Nile state.
Twenty-seven people have died of cholera in the two-and-a-half weeks since the South Sudan Ministry of Health declared an outbreak of the disease in Juba on May 15.
The U.N. humanitarian coordinator in South Sudan, Toby Lanzer, tweeted Monday that the number of cases of cholera has risen to 1,106, nearly double the 586 cases reported a week ago by the World Health Organization.
A treatment center set up just over a week ago in Gudele, a suburb of Juba, by the medical relief charity Doctors Without Borders (MSF) has treated nearly 200 people, including four-year-old Matthew Buru and his two-year-old brother Ludia Wosuk.
Their mother, Mary Keji, said the illness came on suddenly: the boys ate, began crying and immediately started having diarrhea, she said. Health officials have warned that cholera, which is transmitted through contaminated food or water, can kill within 24 hours through rapid dehydration, if left untreated.
Children at risk
MSF medical officer Mduduzi Chandawila said children are particularly at risk of dying if they do not get treatment right away.
The medical officer said malnutrition increases a child's vulnerability to disease -- and the country has seen a spike in malnourished children since violence erupted in December.
"For malnourished children, generally, they are most likely to stay in shock, since they lose a lot of fluids," Chandawila said.
"Even among the old, it is really a challenge. Generally, if they are malnourished, it means that their immunity is really affected,” he said.
Cholera can be treated with intravenous drips or by administering oral rehydration salts. Matthew and Ludia were put on intravenous drips due to the seriousness of their condition, but officials said they expect both boys to recover.
Health officials have launched a vaccination campaign to try to curb the spread of the disease, and an information campaign to raise awareness of the symptoms and risks of cholera.
The information campaign is targeted at people like Mohamoud Ibrahim Guja, who had no idea what cholera was when he fell ill. "When I came home from work, I started feeling weak and vomiting started," he said.
"When I lay down, I almost fell off the bed. I didn’t want to come to the hospital, but my friends told me I had signs it was cholera. I thought it was a simple sickness,” he said.
Guja is on the road to recovery and is expected to leave the MSF treatment center in the next few days.